Sex During Pregnancy: Is It Safe?

The only purpose of using a condom would be if your partner had a known infection that can be associated with complications in pregnancy. This especially is the case where your partner is known to have herpes simplex, a virus that can be passed on via sexual intercourse and can cause complications during pregnancy.

If a pregnant woman has a primary or first infection during pregnancy the virus is then present in the bloodstream of the pregnant woman and can cross the placenta. If the pregnant woman develops a secondary infection that is it is not her first infection, then the presence of the virus adjacent to the birth canal in the case of genital herpes can result in a newborn developing a significant herpes infection via direct contact. Rarer asymptomatic infections in the male partner such as mycoplasma or ureaplasma are an occasional cause of prematurity. In the absence of infection in the male partner, a condom per se is unnecessary. Certainly, a condom is unnecessary to avoid the effect of prostaglandins or oxytocin.

Intercourse in pregnancy in a patient who is not at risk of premature delivery either because of previous premature birth, the presence of a cervical suture or the presence of excess amniotic fluid (polyhydramnios) is not usually associated with the initiation of a premature labour. The important information is that if you have an uncomplicated pregnancy with no factors that already increase your risk of a premature delivery then intercourse is safe.

There is no gestation per se where intercourse is unsafe. In other words, intercourse can safely occur in a normal pregnancy where there are no factors that already increase your risk of prematurity right throughout the pregnancy, that is up until the time you come into labour.

There is no gestation per se which makes intercourse more of a concern.

As mentioned previously, intercourse should be avoided when you have had recent vaginal bleeding, you have a past history of unexplained premature delivery, you have had threatened premature delivery during this particular pregnancy, you have had unexplained vaginal bleeding either as a threatened miscarriage or after 20 weeks as an antepartum haemorrhage, or you have a cervical suture in situ.

With the exception of women who have a cervical suture in situ, intercourse per se is not a cause of miscarriage.

However, if you have had recent vaginal bleeding, intercourse that can trigger bleeding from the cervix may confuse the issue with respect to the presence of an ongoing threat of miscarriage.

The cervix in pregnancy tends to be more vascular and there is an increase in cervical gland cells exposed to the vagina. This in itself increases the risk of vaginal bleeding which can confuse the issue as to whether the threat of a miscarriage is still present. Bleeding associated with intercourse because of the physiological changes resulting in a more vascular cervix is in itself not in any way a cause of miscarriage but can confuse the issue.

Intercourse between couples is a normal healthy part of a relationship. Couples enjoy this aspect of their relationship and it helps to create a stronger bond and perpetuate that bond. Most couples in the presence of pregnancy want to continue their relationship as usual and have the usual level of intimacy is a part of this ongoing normal relationship.

Most women find as the pregnancy proceeds lying on your back becomes more and more uncomfortable and can be associated with a drop in blood pressure and dizziness. Intercourse in this position with a large uterus can become more and more uncomfortable, so therefore the missionary position becomes less comfortable and is not recommended especially after 20 weeks.

A number of couples find that either having intercourse with both participants on their side is often more comfortable. Similarly, with the pregnant woman on top of her partner intercourse is often more comfortable and allows the pregnant woman to have more control especially if intercourse in any way has become uncomfortable. Therefore, the most comfortable and appropriate positions to have intercourse include:

• Intercourse with both participants on their side
• Intercourse with the pregnant women in the all-fours position or especially with a pillow or a number of pillows placed under the pregnant woman’s chest
• Intercourse with the pregnant woman on top

There is no particular position that is unsafe during pregnancy. It is all a matter of comfort and enjoyment.

First of all, pregnant women have a great variation in their actual libido during pregnancy. There is no rhyme or reason to this but it is known that some women notice their libido is increased or heightened during pregnancy and other pregnant women notice that their libido is particularly low during pregnancy.

It is important to realise and acknowledge that each woman will have their own feelings and issues with respect to having intercourse during pregnancy.

It is important also to realise that lubrication during intercourse whilst pregnant may vary and that routine lubricants are safe to use during pregnancy either water-based or oil-based.

It is often important early in the pregnancy to discuss this topic concerning having intercourse during pregnancy. Some women feel particularly anxious and concerned about the safety of intercourse during pregnancy and even though they may be reassured, if anxiety is an issue then obviously intercourse may not be the appropriate course of action.

The best way to avoid any issues is to have an open and frank discussion with your partner and with your treating obstetrician. Often becoming educated about all aspects of intercourse during pregnancy will allow you to proceed with intercourse with minimal or no anxiety and this in itself often helps your libido or sex drive.

In conclusion, it is important to realise that routine straightforward intercourse in a normal pregnancy where there have been no significant complications and where there have been no significant complications in previous pregnancies, is totally safe. Intercourse is obviously part of a normal relationship and there is no reason why that aspect of a normal healthy relationship cannot be continued during pregnancy.